Individual provider Active NPI

Darryl Wayne Zacharia Wisher, R.PH

  • Pharmacist
  • Long Beach, NY
National Provider Identifier
1053635680
Registry record updated Mar 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
042772 Issued in NY
Practice address
790 Park PL
Long Beach, NY 11561-2111
Phone
(516) 620-2862
NPI assigned
Mar 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 135941 NY
Pharmacist 183500000X 042772 NY Primary

Addresses

Primary practice location

790 Park PL
Long Beach, NY 11561-2111

Mailing address

11450 203Rd St
Saint Albans, NY 11412-2815
Phone (845) 309-3657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
042772NYMDPharmacist
135941NYMDEarly Intervention Provider Agency

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1053635680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11450 203RD ST",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114122815",
            "telephone_number": "845-309-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 PARK PL",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612111",
            "telephone_number": "516-620-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHER",
        "first_name": "DARRYL",
        "middle_name": "WAYNE ZACHARIA",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-25",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NY",
            "license": "135941",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "042772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.